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  • Successful use of anakinra for colchicine-intolerant, corticosteroid-dependent recurrent pericarditis secondary to postcardiac injury syndrome after pacemaker placement

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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Successful use of anakinra for colchicine-intolerant, corticosteroid-dependent recurrent pericarditis secondary to postcardiac injury syndrome after pacemaker placement
  1. Muhammad Hamza Saad Shaukat1,
  2. Muhammad Asim Shabbir1,
  3. Sulagna Mookherjee2 and
  4. Ruben Peredo-Wende3
  1. 1 Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
  2. 2 Cardiology, Albany Medical Center Hospital, Albany, New York, USA
  3. 3 Division of Rheumatology, Internal Medicine, Albany Medical Center, Albany, New York, USA
  1. Correspondence to Dr Muhammad Hamza Saad Shaukat, hamzasaad1991{at}gmail.com

Abstract

A 54-year-old woman was referred to our centre for the third recurrence of colchicine-intolerant, corticosteroid dependent iatrogenic post-traumatic pericarditis after pacemaker placement 3 months prior to the first episode. The initial episode and each recurrence were associated with a pericardial effusion requiring drainage. Evaluation for pericardial infection, malignancy, autoimmune disease and pacemaker lead perforation was negative. After fourth recurrence and fifth pericardial drainage in 3 months, a trial of anakinra (interleukin-1 inhibitor), in addition to swift symptom resolution successfully prevented subsequent symptomatic and echocardiographic recurrence. Corticosteroids were tapered and eventually discontinued. At 4-month follow-up, the patient continues to be on daily anakinra 100 mg subcutaneous (SQ) daily without adverse effects.

  • Pericardial Disease
  • Therapeutic Indications
  • Pacing And Electrophysiology

https://doi.org/10.1136/bcr-2018-229117

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    Footnotes

    • Contributors MHSS: involved in reviewing literature and writing the manuscript. MAS: wrote and revised the manuscript. SM: involved in patient care, literature review and critical review of final manuscript. RP-W: conceived the structure and premise of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Qot commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.